We are here to help you understand your health care choices. Your questions are important. This is a good place to start if you want to learn about CCC Plus, health plans, and PCPs.
If you can't find an answer here, call us at 1-844-374-9159 (TTY: 1-800-817-6608).
What is the CCC Plus Program?
Commonwealth Coordinated Care Plus (CCC Plus) is a Medicaid managed care long-term services and supports program. CCC Plus serves over 260,000 people in the Commonwealth of Virginia. People who qualify must enroll in the high-touch, person-centered care program. Managed care organizations (also called health plans) provide medical, behavioral, and long-term services and supports to members who need them.
What is a health plan?
A health plan is a network (group) of doctors, hospitals, clinics and other health care providers. They work together to meet your health care needs.
Can I change my health plan?
Yes. You can change your health plan in the first 90 days after you become a CCC Plus member. After 90 days, you can only change your plan during open enrollment. Open enrollment is in the fall and only once a year. At other times, you can change plans if you get approval from the Department of Medical Assistance Services. To learn more, call us at 1-844-374-9159 (TTY: 1-800-817-6608).
What is a primary care provider (PCP)?
A PCP is a doctor, clinic or other provider you choose to manage your health care. Your PCP will get to know you and your health care needs. Your PCP will help you when you are sick or need a check-up and refer you to specialists when you need them.
What is a care coordinator?
A care coordinator is a person who works with you and your providers to help you get the health care you need. Your care coordinator is your main point of contact and can:
- Answer questions about your health care
- Help you find providers, community resources and social services
- Coordinate your providers through care team meetings
- Help you meet your goals
To learn more, call your care coordinator.
Can I keep my same doctors?
Yes, you can keep your same doctors if they work with a CCC Plus health plan. To find out which health plans your doctors work with, go to Find a provider.
If you have Medicaid
If Medicaid is your only health coverage, you must choose a provider in the CCC Plus health plan network (group). You may ask a provider to join the network. Talk to your provider and your health plan care coordinator.
If you have Medicare
Your Medicare provider does not have to be in the CCC Plus health plan network. They do not need approval for Medicare covered services. Ask your Medicare provider if they accept payment from your CCC Plus health plan for the Medicaid-covered part of your co-insurance, deductibles and co-pays. Take all of your Medicaid, Medicare and other insurance cards to your health care visits.
If you have other insurance
For services covered only by Medicaid, you must choose providers in the CCC Plus health plan network. For services covered by your other insurance, your CCC Plus health plan will pay the Medicaid-covered part of your co-insurance, deductibles and co-pays. CCC Plus Medicaid health plans must pay your co-insurance, deductibles and co-pays if your provider agrees to bill the health plan and accept this payment as payment in full. Take all of your Medicaid and other insurance cards to your health care visits.
What if my current provider does not work with my CCC Plus health plan?
You can keep your current provider for the continuity of care period. The continuity of care period is up to 30 days from when your CCC Plus coverage began. To find a provider, call your health plan care coordinator.
Will I have transportation services in CCC Plus?
Yes. When you enroll in a CCC Plus health plan, transportation is a covered service. It is covered when you do not have another way to get to your Medicaid services.
When you get your CCC Plus welcome packet, you will get a new member ID card. The ID card lists the phone number to call for transportation. You can also find the phone numbers at CCC Plus Transportation Contacts.
If you are on a DD waiver, LogistiCare covers transportation to waiver services. Your CCC Plus health plan covers transportation to non-waivered services. If you are on the CCC Plus waiver, your CCC Plus health plan covers transportation services.
How does CCC Plus affect my Medicare?
CCC Plus is a Medicaid program. You can keep your current Medicare plan. Or you can enroll in a Dual Special Needs Plan (D-SNP). A D-SNP is a Medicare Advantage plan. It covers Part A (hospital insurance), Part B (medical insurance) and Part D (prescription drug coverage). It also coordinates your Medicare and Medicaid benefits.
Learn more about which Medicare health plan is right for you in one of these ways:
- Call the free Virginia Insurance Counseling and Assistance Program at 1-800-552-3402
- Call 1-800-MEDICARE (1-800-633-4227) (TTY: 1-877-486-2048)
- Go to medicare.gov/find-a-plan
- Read the handbook mailed to you each fall, called “Medicare & You”
If you have Medicare, check if you can keep your same providers. Tell your providers that the CCC Plus health plan will pay for your Medicare co-pays and deductibles. Your Medicare providers do not have to be in the CCC Plus health plan network. They do not need a CCC Plus service approval.
You will still pay Part D co-pays for prescription drugs unless you are in the Medicare Extra Help program. You will also pay for long-term services and supports. Your local Department of Social Services (DSS) office will decide how much.
What if the pharmacy will not fill my prescription?
If you only have Medicaid, call your health plan care coordinator. If you have Medicaid and Medicare, call 1-800-MEDICARE (1-800-633-4227).
Who can help me with a bill?
For questions about bills for a Medicaid service, call your health plan care coordinator.
How can the CCC Plus advocates help me?
Advocates can help you with questions, concerns and problems about CCC Plus. They can also help you with enrollment and disenrollment, continuity of care, access to covered benefits, questions about bills and care coordination, and more.
To learn more about how an advocate can help you, call the Office of the State Long-Term Care Ombudsman, Department for Aging and Rehabilitative Services at 1-800-552-5019 (TTY: 1-800-464-9950). Ask to speak with an advocate. Or go to elderrightsva.org.